Abilify, Not I : Adventures in Antipsychotics

Lately, I have written a series of posts over the last two months describing certain troublesome symptoms I associated with the worsening of Bipolar Disorder, or the potential for comorbid disorders.

In my last post, When Medications Go Wrong, I briefly wrote about my recent discontiuation of the pharmocological treatment using Abilify as part of my medication regimen:

Recently, I stopped my Abilify.  Admittedly, it was because I noticed an interaction between the Abilify and my weekend consumption of alcohol.  I started to find that I would fall asleep soon after taking it on Friday’s while we drank.  I decided that I would just stop over the weekend, and continue during the weekdays as normal.  But, eventually, I just forgot to take it at all.  And soon, I started to notice an improvement in my worsening condition.

I went on to describe some of the awful side effects I was experiencing as a result.  However, the list was truncated for the sake of keeping word count down.  The description is rather limited in terms of accurately depicting exactly what I was subject to.

  • Cognition Disturbances and Memory Fragmenting.  Originally, I wrongfully blamed Lamictal in Vitamin L : Medication Adventures for my aphasia-like symptoms.  The disturbances felt like aphasia.  At first, it was almost indescernable.  I started word dropping again, meaning I would be reaching for a word, but was unable to grasp it.  Instead, I would be able to get to every synonym around it, however, those words did not fit the exact context.  Eventually, it became a more severe form of word dropping, and I found myself dropping sentences entirely at the loss of any word or synonyms around it.  It progressed into entirely dropping conversations at the loss of a sentence.  Then, I found myself

    I started forgetting things again.  These were simple things, like losing my purse or shoes in the house.  It seemed like just a simple case of forgetfulness, maybe stress related.

  • Emotional Blunting and Partial Flattening.  I had never had too much trouble with emotional blunting in the past.  While I’ve found myself in times where it was difficult to express my emotions, this didn’t indicate a lack of emotional response.  I describe it as a partial emotional flattening, because it wasn’t an entire lack of reactivity.  It felt like my spectrum of emotions had been significantly reduced, although not completely removed.  There was a certain inaccessibility to certain strong emotions.  Rather than completely removing extreme emotions, it threw a wet blanket on top of them, leaving them to bubble under the surface.  So, the emotions still existed, but were muted and unable to be adequately expressed.

    At it’s worst, I began to lose most feeling entirely, with the exception of irritation and the sensation of boredom and fatigue.  I began to lose love and my attachments to meaningful people and my relationships with them.

  • Dissociation I touched on a summary of the dissociative symptoms that Abilify had brought on.  I have been writing articles on the experience throughout the last few months on the subject, describing the feeling in great detail, but remained unable to exactly identify is appropriately.  The dissociation probably occurred as a response to the prior bullet points.

    The dissociation cited was experienced as a removal of self and removal from my own life.  I had felt as if I had been separated from myself and my world.  It was a feeling of something being stolen from me, or something fundamentally inaccessible.  Like, I was being locked out of my own life, or becoming transparent and just fading away.

  • Worsening of Depressive States.   This is probably a direct result of the first three bullet points.  I started to disengage from my life.  I lost interest in just about everything.  Most things were considered to be either boring or tedious.  Important things started to lose meaning.  This was experienced as a part of the emotional flattening, but it caused a concerning and distressful reaction.
  • Exacerbation of Social Anxiety Since I had lost the ability to carry on a conversation and found myself completely disinterested in socialization, my social anxiety went through the roof.  I simply didn’t care about anything anymore, especially trivial things I used to find interest in.  Therefore, I found it difficult to carry on a conversation.  This caused extreme distress in social situations, and encouraged further isolation.
  • Disturbed Sugar Levels.  While I have no concrete proof in terms of tests, certain symptoms have come to my attention.  They are notated below in the next two bullet points as thirst and weight gain.
  • Loss of Sensation of Bodily Hunger, Thirst, and Fullness.  Within the last few years, I started to become more in tune with my body.  I was able to feel the sensations of hunger through my sugar level, which probably caused the loss of bodily hunger.  The disturbed sugar levels probably also caused an extreme thirst that could not be quenched.  At first, I craved water.  Eventually, I started to put the soda back down, which probably caused part of the weight gain mentioned below.  And I felt an extreme pressure in my stomach, which was also exacerbated by the influx of so much fluid.
  • Extreme Weight GainTruthfully, I don’t dare get on a scale at the moment, so I am unable to notate at this time exactly how much weight I’ve gained.  By the fit of my clothing, I will estimate that I have gained somewhere between ten and fifteen pounds in the last three months.  That is a substantial gain for me, especially since I was losing weight prior to the start of this medication.
  • Exacerbation of Eating Related Problems.  By all definitions, it’s completely possible that I am living with an undiagnosed eating disorder.  However, I am not entirely convinced, since it isn’t an ongoing and prevalent problem.  Therefore, I define it as eating related problems and difficulties.

    The concern for weight gain and the sensation of fullness caused a very terrible reaction of binging and purging.  I was unable to control my eating, as notated above, therefore the sensation of extreme fullness would cause me to perceive the overeating as worse than it actually was.  Unfortunately, this led to a very vicious cycle and encouraged further weight gain.

  • Disturbed REM Sleep.  I was waking up tired, and noticed that it felt like I had stopped dreaming.  This caused my mental state to take a considerable dive.  It caused extreme fatigue and excessive, unproductive sleeping.

While I am cleared of most dissociative symptoms, emotional flattening, and my depressive state is lifting a little, some side effects have remained.

  • Cognitive Disturbances.   The aphasia-like symptoms remain, but to a lesser degree.  I am back to just being a little forgetful, and have some minor word dropping.
  • Memory Fragmenting.   Some of my memories remain dull, but seem to be returning.  However, most of the last three months remains inaccessible.  It may never become accessible, due to the disruption in the formation of short-term memory.
  • Disturbed Sugar Levels.   I am still thirsty, but I am no longer engaging in carbohydrate seeking consumption behavior.  I figure it will take awhile before my sugar is regulated properly again.
  • Weight.   Thankfully, my weight does seem to be coming down.  I have only been completely off of the medication for less than a week, and my clothes are already fitting better.  I’m going to assume that in addition to the weight gain, I was retaining water and constipation.  My regularity has come back, and I don’t feel as puffy as I did

Unfortunately, I am experiencing a return of some of my milder psychotic symptoms.  In Imaginary Enemies, I described a cognitive disturbance I described as “The Voice”“The Voice” can be characterized as a singular persona, as I wrote about in Conscious, Subconscious, and Extraconscious, where I described a theory of a third consciousness that exists between the subconscious and the conscious mind.

The Extraconscious is postulated as where the persona(s) reside, laying in semi-dormant waiting, perfectly aware of the current reality that is being experienced.  “The Voice”, in more severe psychotic states, can be experienced as a separate entity entirely, detached from the consciousness.  That is the defining line between a cognitive distortion and an auditory hallucination, when a persona detaches itself from the extraconscious as an external sensation.

As an extraconscious persona, “The Voice” can best be defined as a quasipersona, lying somewhere between Dissociative Identity Disorder and psychosis.  It is experienced as a semi-active part of the conscious mind, as the dominant persona is well aware of it’s existence and there is a certain interaction that occurs between the dominant persona and “The Voice”.

That is the best theory I can offer as to the existence and function of the quasipersona, known to me as “The Voice”.

The mild auditory hallucinations and visual hallucinations have returned, probably defined better as a sensory disturbance, rather than a symptom of psychosis.  When experiencing a sensory disturbance, it’s not full on hallucinations as described in the definition of psychosis.  There are not entities separate from the body.  They are recognized as a disturbance in the current reality, distorting shapes, colors, and contrast in the vision.  In the hearing, it is experienced as a distortion in sound, causing sounds to be sharper, duller, muffled, or louder than they actually are.  It can only be sensed by a sudden shift in perception.

So, instead of hearing things at a normal sound level, the sound volume may increase to deafening levels or may become muted and difficult to discern from nonexistent static that occurs in the mind.  My visual disturbances may be perceived as viewing the world in high contrast, extremely bright colors, and / or extra high definition resolution.  Or, they may be seen as duller than usual, muting colors, distorting shapes, and / or clouding the vision with that appearance of a veil or foggy goggles.

Intrusive thoughts have returned, but not with the same extreme nature as experienced several months ago.  In truth, they were never completely removed by the Abilify, and at some points were made worse by the drug.  Instead of experiencing them as a truth in reality, I am now able to separate them using logic.  I can talk myself off of the ledge and separate them from the reality of a situation using DBT techniques of mindfulness and distress tolerance.  Prior to the cessation of Abilify, I was unable to utilize those techniques.

I don’t mean to put anybody off of treatment with psychiatric medications, but I felt this was important to document and have as a resource on the internet for anyone who is thinking about taking the drug.  Some of these side effects aren’t listed in the pamphlet, as they are probably isolated to a condition.  But, I feel they are still a distinct possibility for anyone who is being treated for similar conditions.  It is vital that this information be notated and readily available for medication education purposes.  This information probably should not be generalized to all psychiatric medications, especially in the class of antipsychotics.


29 thoughts on “Abilify, Not I : Adventures in Antipsychotics

  1. I have never taken Abilify. The side effects that were openly listed turned me off to it. I experience many of the things you listed as well. Dissociation especially, is a natural means of survival to me. It comes and goes as it is needed. I have mentioned about my extreeme memory loss and fragmentation. Also many others that I won’t go into. But somehow I have learned that it is part of me, and it is up to me to deal with those things. I am at the point to where I don’t want to take anymore mental health meds than I have to. One reason is to learn to deal with me and who I am myself. I know we have talked about this. My memory is what worries me the most. It is embarrassing that when blogging I can not remember how to spell simple words. I have even had to go to google to spell trial and error until I am sure I have it. I mean simple word. I even type a word correctly at one place and then farther down, I can not remember how to spell it and have to scroll up to make sure.
    But this, I mostly blame on the medication itself. Also, the havoc that my brain went through during the breakdown. I nany event, I feel it is my job to try to get my memory back. I hope that it works for you without the Abilify. But I know that there are times when we just can’t control what is happening at all. I have vague and quck halucinations, I hear things, not voices but just “things”. I deal with the issue of volume. I have totally psycotic thoughts for a moment sometimes out of nowhere. But I guess I feel like taht after 12-13 years of this, I am just learning more and more about how to deal with those things and they don’t scare me anymore.

    • I have a problem with spelling now, too. That’s generally why I don’t write posts on my mobile anymore. No spell check.

      I’ve decided that I really want to quit antipsychotics completely. Honestly, maybe this is just a part of who I am. There isn’t a drug to cure a person, just a symptom. I feel like I’m better off with the symptoms than to have a life without them.

      The nastier psychotic breaks were scaring me, badly. Although I’ve had the mild psychosis, as described for, nearly constantly throughout my entire life, I had never experienced full on psychosis. I’ve always had stranger thoughts about things and a lot of delusion. I’m wondering if that is just part of an overactive imagination or not. Either way, I know it’s not “normal”, but is it really a symptom?

      That’s what I’m trying to do now, discern what is symptom and what is personality. Maybe it’s just part of my coping behavioral repertoire. Admittedly, it’s not the best coping skill. But, I feel like I’m losing my mind even worse with the Abilify than without.

  2. Abilify was bad for me too. Not as bad as your reaction, but still not no good.

    Now, I just laugh every time I see the stupid Abilify commercials on tv.

    • I think I’ll get to laughing about it eventually, but I’m still dealing with the fall out.

      What happened with you, if you don’t mind me asking?

      • It was just an immediate, deep dive into the depression. I only wound up taking the Abilify for about 5 days.

        The reaction you had to Abilify sounds a bit like the reaction I had to Effexor.

        It’s weird how wide the range is for medication reactions.

        • I was thinking of starting Effexor as a replacement for Wellbutrin. The Wellbutrin started setting off my anxiety, so I stopped taking it. Since, I’ve been doing better, but I’m not completely convinced that I don’t need an antidepressant at all.

          What happened with Effexor? And what would you recommend for anxiety and depression?

        • I think my issue that I took Effexor and Wellbutrin together and both worked on norepinephrine, so I overdosed.

          It felt like I was on steroids – could have lifted a car into the air. I was extremely dizzy and unsteady. I was really agitated. Even when sitting still, it felt like I was running around the room. I couldn’t control my thoughts. It was pretty scary.

          I only took the Effexor once, because of that reaction so I can’t speak to it as an option for everyone.

          Cymbalta has been working really well for suicidal thoughts. Klonopin worked amazingly well for anxiety but only for about a month, then lost all efficacy.

          Basically, I’m no help because I can list a whole mess of things that haven’t worked for me. From what the doctors say I’m extremely sensitive to meds, so I might not be a great litmus test. Figuring it all out is so frustrating.

        • I’m surprised they put your on Wellbutrin for anxiety. I actually had a warning from my doctor that there was a possibility that could make my anxiety worse. And for awhile, I was perfectly fine on it. Then, I was experiencing a lot of life changes, so I think that’s what sparked this recent series of underlying anxiety and occasional panic attacks. I stopped taking it as a result, because all it was doing was flaring the anxiety and making me agitated.

        • Yea, I actually switched psychiatrists not long after the Effexor incident and the new guy took me off Wellbutrin immediately because it exacerbates anxiety. I didn’t notice an anxiety increase when I was taking the Wellbutrin, but did feel less anxiety after I stopped taking it.

        • I think I might give the XL a shot and see how that goes. I was taking the SR and I know it has a short half-life. I’m so reluctant to give it up, because I’ve seen so much success on it in the past.

          I started taking my Xanax the way I should again, and it’s finally helping again, instead of just making me high. There must have been some nasty interaction Abilify gave me.

  3. So useful! I’m glad you wrote this!

    • Thank you! I really wanted to put it all out there, because it seemed like I experienced some of the stranger things that may or may not happen. Those are things that informational sheets don’t tell you about. I think that’s really unfair not to list all of the potential things. But, then again, doctors probably recognized some of it more as symptom of something else, rather than an effect that the drug produced.

      I’m not really prone to dissociation. The only time I’ve really experienced it was during my psychotic breaks in the spring and summer. It became a coping mechanism. I started to break with reality, but never really entirely. To have it on it’s own is really scary.

      And that’s how I could identify it as a symptom. It didn’t really exist before Abilify.

      • I agree with you! I’ve lost all faith on big pharma because I’ve always experienced the “rare” side effects that no one talks about and then people get mad at me when I talk about it. (Well, the people who haven’t been on those drugs and know how messed up they can be)

        It’s always important to know what you were like before starting a medication. Doctors and such seem to like to link some of the side effects, like your experience with dissociation, with us and not the drug!

        You should write pharmaceutical fact sheets!

        • I would, but I am usually a person who gets the rare side effects, just like you. Sometimes I wonder if they downplay the “rare” ones, just because they are so bad. They probably don’t want to scare people off.

          I don’t blame them, because there are a lot of people who have benefited from these medications. I read about it all over the internet. But, what you don’t read about are the really bad side effects. That’s why I was so compelled to write this.

        • Oh I have thought the same thing! Especially when I talk to others, like yourself, and find that we’ve had similar experiences!

          We need to be educated and with that may come a fear of the medication but just after my experiences I don’t want to be blind to that information again.

        • Neither do I. That’s why I’ve been thoroughly researching medications before I go to see my Pdoc again. I don’t want to be blindsided again. I don’t blame my Pdoc, because he was just trying to do his job. I blame myself for not being as educated as I should have been.

        • We are only as educated as the people who put out the information want us to be. I read somewhere that many doctors are not reading as much of the new research as their patients are!

  4. My pdoc gave me Abilify to try to help me sleep. Of course, it had the exact opposite effect. I was crazy anxious, wound up, and panicky. Howdy, insomnia, nice to see you again. I took one dose, and then threw the damned stuff out.
    Though I’ve met some people who swear by it.
    I hate not being able to drink.

    • The doctor knows I have a problem with alcohol, and that problem doesn’t really go away. I don’t really have an abuse problem right now, it’s more of a social use thing, although it could go really bad at any time. And he still prescribed it without even warning me about the alcohol interaction. I mean, sure, all of the drugs come with that warning. But, I never really take it seriously, because I’ve drank with a lot worse than that!

  5. I had a terrifying week long experience with Abilify about six years ago. After taking the med without incident for five days, day six found me in a bar at 10 AM drinking whiskey and dancing on the bar top and smoking cigars….three things I never do under normal circumstances. I was passed out in bed by 1 pm that day and woke later feeling agitated and suicidal. It took about a week for the medication effects to wear off and I never took it again. Big pharma simply does not know enough about this meds potential effects. Scary stuff.

    • I agree that when a new drug is released, they simply just don’t know enough about it. And what disgusts me even more is the fact that they release theses drugs knowing that. Just because it completed a series of clinical trials without killing anyone (or too many people) doesn’t mean that it’s safe, or won’t have severe effects like these.

      It’s awful to hear that you went through that, and I can’t imagine it. That’s something I failed to mention was the alcohol cravings. I found myself standing in front of my bar at home, considering starting to drink in the day. I haven’t done that since before I was diagnosed, and even then, it was a rare impulse.

      Another thing they don’t tell you is that it takes awhile for it to clear out of your system, like you mentioned. I’ve still been suffering ill effects. There’s a new one that I didn’t mention yet, and that’s the extreme stomach upset. It messed up my sugar and my eating so badly that everything is out of whack. Now, I feel too full all of the time, and I know I didn’t over eat. And if I’m not snacking throughout the day, I become entirely too hungry.

      And the thirst! I’ve been drinking so much water that I’ve actually made myself sea sick from the contents of my stomach swimming around!

      Ridiculous. I’m not going to say that I blame Big Pharma entirely, because it was my choice to take it. But, they should have warned about these things. Heaven knows there must be some kind of isolated data somewhere that they just considered to be a blip on the radar!

  6. Sounds like that stuff has more side effects than the gas station dinner I just ate 😦

  7. I have been on Abilify for around 5 months and have experienced many of the symptoms described in your article. However the most troubling symptoms is the memory loss, loss of concentration, drowsiness, and mental dulling. I had experienced Psychosis twice back in October and once in November for a week’s duration. First I was placed on Geodone which made me literally go crazy and then i was switched to Abilify. I have been complaining to my pdoc for quite some time of the fragmentation but I do not think she sees it as serious and problematic as I do. I want to be able to read as effortlessly as I did before without having to re read the passage and search for meaning. I wanted to know if you were able to regain your mental acuity after you stopped taking abilify?

    • It took awhile, but the side effects subsided. It’s been more than a year since I stopped it, and I wouldn’t say it had any long term impact.

      Before I go on, I’d strongly advise getting a second opinion. Another doctor may have a fresh perspective.

      It’s been two years since my last full blown manic episode. It was also the worst I can recall, but I had only been diagnosed for three years at that point. I was willing to do anything to rid myself of that mania. I had gone so far beyond my breaking point that every minute of my life was a struggle to hang on. And that’s why I went on Abilify. I was actually terrified that I’d be in that state indefinitely.

      It didn’t actually help. I mean, it took care of the psychosis, but it left me with a whole new set of problems. And those were symptoms that I wasn’t familiar with.

      For me, I decided that the devil I didn’t know was way worse than the devil I did. I didn’t want to take another spin at the medication roulette table. I decided that there had to be an answer beyond the scope of medicine.

      I don’t suggest it without being supervised by a doctor. Very seriously.

      Here’s a spot of good news. I have not had a very serious extended episode since last winter. That was a year ago. I should not have been shocked when I plunged into a deep, five month long depression after a six month long manic episode.

      I’m still having symptoms. Just like all of the medications advise, they don’t stop symptoms. They just lessen them. So, I decided that I would have to find a way to deal with the symptoms without tweaking my meds every time they pop up.

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